From organic lettuce to hormone-free milk, healthier food just costs more. But meal managers at local hospitals said they’re finding ways to improve the quality of their menus without plowing their budgets under.

Across the county, hospitals are revamping their menus — adding a scoop of brown rice here and a bunch of bok choy there, shutting down deep fat fryers and pushing sodas to the bottom shelf of the cooler.

These days, health providers are under pressure to become role models for the communities they serve by showcasing food habits that can help keep patients out of hospital beds in the first place.

Providers in the San Diego region are getting the message, said Seema Wadhwa, director of the Healthier Hospital Initiative, a nationwide campaign that challenges medical centers to do better on the food front. “It’s a matter of practicing what we’re preaching,” she said.

HEALTHIER FARE

Local hospitals are adding healthier menu items in their cafes and for patients staying overnight. Here’s a sampling of those foods:

Pomerado Hospital in Poway, for example, is getting ready to launch a new menu for its patients that skews noticeably lighter. Mashed potatoes and gravy, currently a listed option on lunch and dinner menus every day, will be available only by request starting next month, said Javier Guerrero, Pomerado’s food and nutrition services manager.

And it’s the same deal in the hospital’s cafe, where some employees line up at a pasta bar for “noodles” that are made of long, thin strands of zucchini cooked hot and fast with vegetables and sauces designed to deliver flavor without too many calories.

Though zucchini pasta might seem like a hard sell for hospital workers who often have high-stress jobs, Guerrero said he has seen double-digit percentage increases in sales since introducing healthier offerings last year. “If the food tastes good, they’re going to buy it,” he said.

And this food is not the same old stuff in new packaging. Pomerado now buys 47 percent of its produce from local suppliers or from those that use sustainable-growth methods. Scripps Health, which operates four hospitals on five campuses in the region, now gets 60 percent of its produce from California.

Mind the meat

To afford the higher price tags that come along with sustainable, organic and local food sourcing, some hospitals have migrated their menus away from meat.

Joe Libertucci, director of food and nutrition for Kaiser Permanente San Diego, said the organization has reduced the amount of meat it uses in meals, both those that patients receive in their rooms and those that employees and visitors can order in the cafe at the health system’s main hospital on Zion Avenue in San Diego.

“We have decreased animal protein at the same time as we have increased our use of vegetables and whole grains,” Libertucci said.

Relying less on meat frees up room in the budget for better produce, he said, and it enables Kaiser to focus on the quality of meat still purchased. Kaiser is buying antibiotic-free chicken and will soon start ordering antibiotic–free beef raised in Uruguay.

Palomar is working with the same food supplier as Kaiser’s.

“We’ve decreased meat consumption 10 percent year over year,” said Barbara Hamilton, Palomar’s system sustainability manager, adding that her organization has adopted a “meatless Mondays” policy as part of the shift.

A chef prepares a meal of "noodles" made of long strands of zucchini at Pomerado Hospital in Poway. A new report, released Monday, emphasizes adopting a more plant-based diet to reduce cancer risk.
— Charlie Neuman

+Read Caption

A chef prepares a meal of "noodles" made of long strands of zucchini at Pomerado Hospital in Poway. A new report, released Monday, emphasizes adopting a more plant-based diet to reduce cancer risk.
— Charlie Neuman

Hamilton noted that suppliers have not traditionally carried antibiotic-free meats, but said hospitals banding together and demanding the products has forced huge food suppliers to take notice. “As there is more demand, we will be able to get the pricing down so that we can increasingly afford it,” she said.

Wadhwa, the Healthier Hospital Initiative director, said there is evidence in other places that the group purchasing power of hospitals, often among the largest employers in any community, can drive decision-making for local farmers as well as national chains. “When the market sees there is enough of a demand, they may be able to adjust their pricing,” Wadhwa said.

Price controls

Hospitals also are using prices to help employees and visitors see the cost of opting for a pile of French fries over a baked potato.

Tina Pickett, senior director of facilities and support operations for Scripps Health, said the system created a $5 “eat well special” that’s now offered at all of its hospital cafeterias. In addition, those cafeterias have been renamed “color cafes” in a nod to the varied hues on a plate of nutritious food.

French fries are also available, as are sodas and other less-healthy items, but they cost more.

She added that another part to switching to a healthier pattern has been reducing portion sizes.

“If you want a brownie, it’s smaller than what we were offering before. If you want to have the same size as before, you will have to buy two, and it will cost you more,” Pickett said.

Portion size also has been a focus for Kaiser Permanente San Diego. Besides being better for diners’ health, cutting back meal portions has yielded savings that can be used to balance the higher cost of superior produce, Libertucci said.

Smarter choices

Of course, none of these organizations will cite keeping costs flat as the main goal of their evolving food programs. These are the places San Diegans go to get well, and these initiatives are really designed to help develop healthier eating habits.

Soft drinks have been a big target of this effort, with many local hospitals adopting “stoplight” labeling for the drinks they sell. Those with the least sugar get green labels; those with the most are labeled red.

The red drinks are still there, but they might be on a lower shelf, with healthier drinks right at eye level.

“We’re not taking away all of the bad things, but we’re driving the sales to the healthier items,” said Hamilton at Palomar.

Fried foods are another prime target.

In 2012, Kaiser Permanente San Diego removed deep fat fryers from its kitchens and no longer serves fried foods on its premises. Scripps Health’s hospitals haven’t gone quite that far, but in addition to charging more for that plate of French fries, the system has instituted a fryless Fridays program.

Pickett, the Scripps operations director, said the push toward healthier food is simply “the right thing to do” even if it does cost a bit more. And she added that there is still a long way to go. “Every day, we surge forward a little more,” Pickett said.

FOOD PURCHASES

Last year, the group San Francisco Bay Area Physicians for Social Responsibility surveyed 85 medical facilities in the state, including 15 in San Diego County, to gauge their food-purchasing patterns. Here are the percentages of sites polled that bought the following items: